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When a child or adult has a speech disorder they are unable to produce sounds correctly or fluently and/ or they may have problems with their voice. Difficulties pronouncing sounds and stuttering are a few examples of speech disorders. These difficulties may start in childhood when they are learning new words, most children make minor pronunciation mistakes while learning to speak, however if the mistakes continue past a certain age, that tends to be a sign of a speech disorder. Adults may also find they have a speech impediment; this can be a result from a childhood disorder that was never resolved or occur from a stroke, head injury, or another trauma. According to the American Speech-Language-Hearing Association there are five major speech disorders: childhood apraxia of speech, dysarthria, orofacial myofunctional disorders: articulation and phonological processes, stuttering and voice.
Childhood Apraxia of Speech
Childhood apraxia of speech (CAS) is a motor disorder, meaning that the brain has difficulty sending the message to the tongue, lips, and jaw so they are able to move correctly and form the appropriate positions for a specific word and pronunciation. A few signs to look for in children ranging from a very young age to an older age are: does not coo or babble as an infant, first words are late, and they may be missing sounds, may have problems eating, makes inconsistent sound errors that are not the result of immaturity, can understand language much better than he or she can talk, and sounds choppy,or stresses the wrong syllable or word. To an unfamiliar listener people with CAS may be difficult to understand. Children with CAS “may also have difficulties with fine motor skills and are over or under sensitive in their mouths (e.g., may not like tooth brushing or crunchy foods, may not be able to identify an object in their mouth through touch)” (ASHA).
Dysarthria is also a motor disorder that may affect the lips, tongue, vocal folds, and/or diaphragm. The parts of speech that are affected are determined by which nerves are impacted. A person with dysarthria may demonstrate the following speech characteristics: “slurred,” “choppy,” or “mumbled” speech that may be difficult to understand. Slow or rapid rate of speech, limited tongue, lip, and jaw movement, and abnormal pitch and rhythm when speaking. Dysarthria may be brought on by stroke, brain injury, tumors, Parkinson’s disease, ALS, Huntington’s disease, and MS.
Orofacial Myofunctional Disorders
Orofacial Myofunctional Disorders (OMD) occurs when the tongue moves forward in an exaggerated way during speech and/or swallowing. OMD can be caused by allergies, enlarged tonsils and adenoids, excessive thumb or finger sucking, lip and fingernail biting, lip picking, teeth clenching and grinding, and family heredity.”If a child has OMD they may have difficulty with articulating sounds like /s/,/z/, “sh”, “zh”, “ch” and “j” (ASHA). For example, the child may say “thumb” instead of “some”.
Stuttering effects fluency and is characterized by disruptions in the production of speech sounds. Stuttering is not necessarily a problem, however it tends to impair communication. Repeating words and having others are preceded by “um” or “uh” is considered stuttering, and some may limit their participation due to their stuttering; they may become self-conscious and frustrated when trying to communicate with others.
Voice disorders effect exactly what it says, the voice. Colds, allergies, bronchitis, or cheering/ yelling can result in becoming hoarse or a loss of voice. The vocal cords may develop nodules, polyps, or paralysis. Nodules are growths on both vocal cords that are caused by vocal abuse. Over time, “overuse of the vocal cords results in soft, swollen spots on each cord that develop into harder, callous-like growths” (ASHA). Polyps are similar to nodules, but instead of a callous, they are more like blisters.”Bilateral vocal cord paralysis involves both vocal cords becoming stuck halfway between open and closed. This condition often requires a tracheotomy which protects the airway when the person eats” (ASHA). Unilateral vocal cord paralysis is when only one side is paralyzed. The paralyzed vocal cord vibrates abnormally or not at all. The individual will run out of air easily and not be able to speak clearly or loudly. Paradoxical vocal fold movement is another voice disorder that does not happen all the time, but when it does the vocal cords close when they should open, such as when breathing. All of the above listed can be treat medically or behaviorally.
The final voice disorder is spasmodic dysphonia. “Movement of the vocal cords is forced and strained resulting in a jerky, quivery, hoarse, tight, or groaning voice. Vocal interruptions or spasms, periods of no sound and periods when there is near normal voice occur”(ASHA). As of now there is no cure for spasmodic dysphonia, but there are some treatment options for voice improvements such as botox injections. The botox weakens the laryngeal muscles and results in a smoother voice because of less forceful closing of the vocal cords.